Plantar Fasciitis can have a natural recovery when it is acute (less than 4 weeks old). However, the chronic case, over 4 weeks’ duration, often needs intervention to aid full recovery.
If you have Plantar Fasciitis or heel pain for the first time and have had it for less than one months and done little for recovery, follow the protocol below for 4 weeks.
If you don’t get adequate recovery, please contact us and we will help you get a full diagnosis and advise you about treatment and give you up to date advice about recovery protocols.
1st Instance of heel pain 1hr-1week
Inflammation has started where the plantar fascia (a deep skin that runs from underside of toes to the underside of the heel) attaches to the heel. This is because the Plantar Fascia has thickened/stiffened and is most likely due to overuse (please see conditions section for more information). The best treatment for inflammation, at this stage, is rest and ice.
Ice means ice or ice pack, please don’t use peas or any other produce, apart from being unhygienic the cool temperature won’t stay at low enough temperature for the length of time needed to make a clinical effect.
Hold ice on the underside of the foot for a maximum of 10minutes and NO LONGER! However, after 1 hour the process can be repeated.
We always get the question "how often should I ice?" The answer is as often as you can especially in the first 24-48hrs.
The REST part is simple but often hard to implement. As we are based in London we see many public transport commuters. This makes us aware of the difficulties of getting sufficient foot rest while managing a city lifestyle. In this situation, we recommend doubling up on socks and wearing the most comfortable shoes. Trainers are often recommended for people who walk longer distance during the working day.
Sub-Acute Stage: 1 week - 1.5 months
If you have been tenacious about the above protocol and have had little to no effect. You probably have a fault in how the foot operates. This might be noticeable either during standing or when you run. We would recommend a consultation at the clinic for a full evaluation of these faults.
If, however, you have found some recovery there is hope! You can now start stretching and using a technique called self-myofascial release (a self-massage). You will need two extra apparatus to start:
- Large/long towel
- Rolling pin.
We would recommend heating the foot in a bath or bucket of warm water for 10 minutes before stretching.
After heating sit on the floor with legs outstretched and back straight.
Hold towel at each end and place affected for in the apex of the towel sling.
The ball of the foot should be the most towels covered.
Now curl the toes up. They should go from pointing at the ceiling to your face.
Apply a pull through your arms until you feel traction on the underside of the foot.
Rolling pin massage:
Buy a cheap rolling pin.
After warming (10 minutes) foot place rolling pin on the floor.
Place underside of the foot on rolling pin and place 10% more body weight onto the foot attached/resting on the pin.
Now roll the foot/ plantar fascia out by moving the affected leg in a rhythmical shuffle forwards then backwards.
The massage effect can be increased by pointing the toes up to the ceiling.
NOTE: Some people like to cover the rolling pin in a few layers of cling film for hygiene reasons.
WARNING: Each pass might hurt but you should aim for at least 3-6 passes every morning and evening.
Chronic Stage - 1.5 months and onwards
If you have tried all of the above, you should know that each passing day reduces the likely hood of self-recovery. Some kind of manual therapy (Physio, Osteopathy or Chiropractic) is normally sourced by most individuals at this point. These treatment choices will be very similar to the above stretches. However, these traditional techniques statistically offer little results, at this stage. This poor recovery is especially the case in chronic Plantar Fasciitis. This is where Shockwave Therapy can be the lifeline for chronic heel pain.
Needless to say, you might go and see your GP who will probably talk about a referral to an orthopaedic surgeon. This will open two options:
Injection therapy - This will diminish pain straight away but often won't deal with underlying cause meaning it may come back. This is backed up by the poor statistics for long term results.
Surgery - This actually has very similar results to Shockwave Therapy for chronic heel pain cases. It does mean considerable down time post-surgery and anaesthesia risks. "More importantly once you have surgery you can’t go back. This is why we feel shockwave therapy is the best choice."
These invasive choices are often not what people want. Our effective alternatives help heal both the foot and ankle discomfort without invasive techniques. Please look at the other heel pain solutions on this site.
NOTE: Shockwave Therapy (ESWT) is not yet available on the NHS and very few orthopaedic surgeons offer the therapy in the UK.
At the London Foot Pain Clinic, we offer a nonsurgical alternative that takes away heel pain in more than 80% of people who undergo the therapy and then we follow up by supplying orthotics designed for the purpose. This approach is holistic and through: we deal with the pain and its cause.
Looking for a non-surgical solution to your heel pain? Call Us Today. 0208 543 5477